Four ECG Pitfalls That Punish Anchoring Bias

UMEM Potpourri ECG Cases with Dr. Amal Mattu

HPI

A 43-year-old woman with sharp left-sided chest pain and minimal cardiac risk factors has an initial ECG that is not diagnostic for STEMI. She looks stable, but one feature on the ECG is hard to ignore:

Before watching this week’s workout, review the arrival ECG carefully and consider:

    1. What ECG finding should make you worry about very early occlusion even when there is no clear ST elevation?
    2. If cardiology declines cath activation based on the initial tracing, what is the most important next step you should take in the ED?
    3. What key diagnosis can still be present in a younger woman with few traditional risk factors, and how might the ECG evolve over minutes?